Identification of strategies to optimize pain management in people with dementia living in nursing homes using nominal group technique

INTRODUCTION: Pain management for people with dementia is widely recognized as a challenge for healthcare personnel. Multifactorial and comprehensive person-centered care models that recognize individual abilities and resources are warranted but remain lacking in nursing homes. This study aimed to provide a comprehensive perspective on how pain management for people with dementia living in nursing homes can be conducted in a way that includes and supports their individual resources. METHODS: We conducted eight group interviews with a total of 28 nurses providing care for people with dementia in nursing homes. The group interviews followed the four steps of the Nominal Group Technique: (1) Generating ideas, (2) Round Robin technique, (3) Group discussion and (4) Voting and ranking. A thematic framework with eight key themes was developed based on the ideas generated during the interviews. Ratings were compiled and presented thematically. The thematic framework subsequently served as the basis for analyzing the transcripts from the group discussions, providing an in-depth description of the identified themes. RESULTS: A total of 112 ideas were generated, from which eight key themes were identified. The themes "mapping and assessment in the presence of clear pain expression" and "ensure appropriate competence" was ranked as most important. The mean feasibility of the idea's included in the themes was rated slightly lower than their relevance. The findings highlight the need for comprehensive pain management models addressing multiple dimensions simultaneously, grounded in professional competence and supported by relational and informational continuity.